From the Airport to Arms: How A Flu Immunization Program Works in Mongolia

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Donated Flu Vaccine Arrives in Ulaanbaatar
Temperature-controlled crates containing the flu vaccines wait to clear customs at the airport of Mongolia's capital city, Ulaanbaatar. PIVI's pharmaceutical partners donated 175,000 doses of the flu vaccine to Mongolia's seasonal influenza immunization program. In addition to managing the donations, PIVI assisted the ministry of health in implementing and evaluating the three-month-long immunization campaign that began in September 2017.
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Storing Flu Vaccine at the Right Temperature
Proper storage and handling is critical to ensuring the safety and integrity of flu vaccine. The flu vaccine can be rendered useless if it is exposed to temperatures that are too cold or too hot.
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Transporting Vaccine to a Cold Storage Facility
Mongolian ministry of health officials transport flu vaccine to the cold chain warehouse in Ulaanbaatar. PIVI began working with Mongolia in 2016 to strengthen its infrastructure and provide technical expertise so the country would be able to implement flu vaccination programs effectively. A robust flu immunization program can equip countries with the necessary mechanisms to deal with a pandemic or another disease outbreak.
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Cold Storage Crucial to Ensuring Flu Vaccine Remains Effective
In chilly Mongolia, the challenge is to ensure the vaccine is not exposed to extreme cold. Before reaching clinics, flu vaccine is initially stored at a temperature-controlled warehouse at the National Center of Communicable Diseases in Ulaanbaatar.
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Ensuring the Integrity of Flu Vaccine
The national immunization program head and a colleague examine the donated vaccines to check expiration in the cold chain warehouse. With the increased number of donated vaccine in 2017, the program was able to target larger numbers of people especially high-risk groups such as children, the elderly, pregnant women and those with certain chronic diseases.
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Portable Coolers Protect Vaccine During Transport to Clinics
Signs on cold storage boxes specify the temperature that the flu vaccine must be kept at during transportation. PIVI collaborates with countries to build their capacity around efficient and reliable vaccine delivery – getting vaccines quickly and safely to the populations most at risk.
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Flu Vaccine Arrives at a Healthcare Facility
Health workers arrive at a healthcare facility with the vaccine in portable coolers. PIVI held a capacity building workshop in Mongolia last year to help the national program plan, implement and evaluate the effectiveness of its flu vaccination campaign. The training was further reinforced at PIVI’s annual meeting this year where partner countries like Mongolia discussed common challenges and opportunities and gained an understanding of tools for program evaluation and program improvement.
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Ulaanbaatar Residents Queue for Free Flu Shots
Resident of Ulaanbaatar wait in line for free flu vaccines. In 2017, in addition to the flu vaccine doses PIVI provided, Mongolia contributed 45,000 doses to the national immunization program. The success of these programs depends on their ability to be efficient and sustainable in the long term. At the annual PIVI meeting, countries like Mongolia learned how each of them can work with PIVI to create a multi-year plan to guide program growth and sustainability.
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Babies, a High Risk Group
The best way to protect infants from the flu is to make sure they get a flu shot each year before flu season. Flu shots cannot be given to babies under six months. When a child gets a flu shot for the first time, they require two doses, spaced four weeks apart.
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Protecting School-age Children Against the Flu
School-age children here wait for their shot. Children under five years of age are at high risk for developing serious flu-related complications that may require hospitalization or emergency care. The flu vaccine may be given at the same time as other vaccines
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Elderly at Risk for Flu Complications
The elderly are vulnerable to developing complications from the flu and needing hospitalization. This is because the immune system weakens with age and becomes less effective at fighting infections including the flu. Mongolia has a relatively young population with less than ten percent of its people above 65 years of age.
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Pregnancy Increases Risk of Flu Complications
Pregnant women are usually a high priority group for seasonal influenza vaccination programs. This population is at high risk of complications from the disease including miscarriage and birth defects.
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Protecting Healthcare Workers Against the Flu
Immunizing health care workers is often the first line of defense and ensures that they remain healthy so they can help others. PIVI works with the ministry of health to train health workers on how to store and administer vaccines effectively.
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Raising Awareness about the Flu Vaccine
Educators and childcare staff can help slow the spread of flu if they know more about it. In many parts of the world, few realize the dangerous turn influenza can take if adequate precautions are not taken. Here a health care worker talks to a childcare provider about the benefits of vaccination and what flu symptoms to watch for in children.
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Protecting Nomadic Populations Against the Flu
While about half of Mongolia’s 3 million-plus population lives in Ulaanbaatar, around a third are nomadic herders, moving their yurts or gers from place to place. One of the reasons Mongolia’s immunization coverage is high is because the government has made every effort to reach these itinerant populations, sometimes requiring health workers to take the vaccine on horseback. PIVI is already working with Mongolian health officials on their 2018 flu vaccine campaign.

Seasonal flu vaccination programs can be a critical component to help countries combat disease outbreaks and pandemics. The Task Force’s Partnership for Influenza Vaccine Introduction (PIVI) works with low and middle-income countries to build and develop their flu immunization programs. The systems used for these programs can be harnessed in the event of an outbreak of a virulent strain of flu or other infectious diseases.

These pictures from Mongolia show how a flu immunization program works, and how PIVI works with local officials and partners to ensure that the vaccines safely and effectively reach the people who need it the most.

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